Resection arthroplasty of the proximal humerus following chondrosarcoma removal and reconstructive failure: A case report with 22 year follow-up

Abstract

Introduction: Proximal humeral reconstructive alternatives in orthopedic oncology are well described, but the literature regarding post-failure salvage is sparse. This report details a multiply failed humeral reconstruction that ultimately resulted in resection arthroplasty. Although initial tumor resection was treated with an intercalary reconstruction, this case is unique in that its sequelae are equally applicable to failures of proximal humeral reconstruction. Case presentation: We report a 61-year-old Caucasian woman with ultimate removal of a second proximal humeral reconstruction twenty-two years after initial grade I chondrosarcoma resection, leaving essentially a shoulder resection arthroplasty Conclusion: The patient’s acceptance of resection arthroplasty in this case suggests that not all failures of proximal humeral major reconstructive procedures need to be revised to another reconstruction. Resection arthroplasty is much less complex than revision surgery, requires little healing time, expedites recovery, minimizes subsequent further complications and allows for excellent pain relief. Resection arthroplasty may be a plausible approach after failed orthopedic oncology humeral reconstruction in carefully selected patients. Keywords: chondrosarcoma; resection arthroplasty; reconstruction; musculoskeletal tumor; intercalary allograft; proximal humerus; shoulder; shoulder arthroplasty